Almost half a million healthy women at high risk of breast cancer could be offered a daily pill to help prevent the disease.

Tamoxifen should be given to those women who have a history of the disease in the family, according to NHS guidance.

Taking the drug for five years – costing just £120 in total – would cut the risk by more than a third.And the protection could last 20 years, according to clinical trials.

New NHS guidance says tamoxifen will give women at high risk an alternative to having their breasts removed as chosen by celebrities including Angelina Jolie and Sharon Osbourne

It will provide women with an alternative to having their breasts removed, as chosen by Angelina Jolie and Sharon Osbourne.

Tamoxifen has been used for almost 40
years to treat breast cancer. But now the National Institute for Health
and Care Excellence says it and another drug called raloxifene should
be used for prevention.

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It says they are cost effective and likely to save the NHS money by cutting cases of the disease.

Trials show tamoxifen can prevent 35
to 45 per cent of breast cancers, with a similar reduction from
raloxifene, which is used to treat osteoporosis in women who have gone
through the menopause.

It is the first time any health
service has issued such widespread guidance, which could affect 3 per
cent of women aged 35 and older – around 488,000 – in England and Wales.

Sharon Osbourne also opted for a mastectomy. But instead women could take the drug Tamoxifen for five years - costing just £120 in total - and cut their risk by more than a third

They will be eligible if they have a
family history that puts them at high risk, with a lifetime chance of
developing breast cancer that exceeds 30 per cent, or ‘moderate’ risk of
between 17 and 30 per cent.

Currently high-risk women can be
offered annual MRI scans from the age of 40. Under the revised guidance,
which also covers 400 men diagnosed with breast cancer each year, women
with some genetic mutations will be offered annual scans from the age
of 20 to 49.

The new guidance says women at higher than average risk should be offered surveillance at younger ages to detect the disease earlier

Women at moderate risk could get
annual X-ray scans from the age of 40, while others could get annual
checks after 50 instead of every three years with the routine NHS
screening programme.

But the most controversial plan is for the drugs to be prescribed as
preventive therapy, as they are not licensed for such use here, although
they are in the US.

The lifetime risk of breast cancer is
one in eight, and almost 50,000 women a year are diagnosed with breast
cancer. Of these, around 2,400 patients have inherited faults in known
breast cancer genes, while a further 5,000 to 7,000 women are affected
by genes not yet identified.

The guidance, which supersedes advice
issued in 2004, says people with a 10 per cent risk of developing the
cancer should be offered genetic testing – the current threshold is 20
per cent – which should double the numbers eligible for a blood test.

Professor Gareth Evans from St Mary’s
Hospital in Manchester, who helped develop the guidelines, said: ‘This
treatment is potentially not just cost-effective but cost saving to the
NHS and more importantly for women they don’t have to go through the
stress and trauma of a diagnosis, radiotherapy, potentially
chemotherapy.’

Prof Evans said women whose risk of
breast cancer was 80 per cent or above may still opt for surgery, which
virtually eliminates the risk.

Menopause-like side-effects such as
hot flushes usually stop after the first six months, and more serious
problems are rarer, he added.

Susan Heard, an NHS nurse specialising in breast care, said today that the drug could be a viable alternative to preventive mastectomy, which many women are wary of 'for lots of medical reasons but also for psychological reasons'.

She told BBC Radio 4's Today programme, 'We will never be able to tell women exactly on an individual basis whether or not they're going to develop breast cancer,' but added: 'Research is going on all the time to hone in on the people who will develop breast cancer.'

Ms Heard also said that some local NHS trusts were already offering tamoxifen as a preventive measure, which will now be available to women no matter where they live.